Patient Group Direction Hepatitis A vaccine Version: Hepatitis A 2015 Start Date: 1 st July 2015 Expiry Date:30 th June 2018

Transcription

1 Patient Group Direction Hepatitis A vaccine Version: Hepatitis A 2015 Start 1 st July 2015 Expiry 30 th June 2018 THIS PATIENT GROUP DIRECTION HAS BEEN AGREED BY THE FOLLOWING ORGANISATIONS: BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST CUMBRIA PARTNERSHIP NHS FOUNDATION TRUST EAST LANCASHIRE HOSPITALS NHS TRUST LANCASHIRE CARE NHS FOUNDATION TRUST NORTH CUMBRIA UNIVERSITY HOSPITALS NHS TRUST UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST CLINICAL COMMISSIONING GROUPS: BLACKBURN WITH DARWEN BLACKPOOL CHORLEY AND SOUTH RIBBLE EAST LANCASHIRE FYLDE AND WYRE GREATER PRESTON LANCASHIRE NORTH WEST LANCASHIRE Change history Version number Change details Date Hepatitis A Review 10 March 2015 [Type text]

2 CLINICAL CONTENT OF PATIENT GROUP DIRECTION FOR Patient Group Direction Details VERSION (Page 1 of 4) Date comes into effect 1 st July 2015 Date of expiry + review 30 th June 2018 or sooner in the light of significant changes in best practice Staff characteristics Registered nurse or Pharmacist employed by the NHS organisations overleaf or independent contractors within them, who has completed immunisation and vaccination training (theoretical and practical) as per local policy, training in the recognition and treatment of anaphylaxis, including practical training in Basic Life Support (annual practice update session to be undertaken) and working under PGDs. Access to adrenaline and access to the complete updated relevant chapters in the current edition of the Green Book Immunisation against Infectious Disease. Clinical Details Indication >> YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION << >> OF THIS PGD BEFORE WORKING UNDER IT << This PGD is to be followed by all nurses and pharmacists who carry out immunisations in hospitals, clinics, schools, surgeries, patients homes or other locations. Facilities for treating anaphylaxis must be available. Immunisation against Hepatitis A infection. Inclusion criteria Individuals who are at risk of infection from hepatitis A due to:- travel to or going to reside in areas of moderate or high endemicity, chronic liver disease haemophilia at risk of infection due to contact with a case of hepatitis A occupational or lifestyle factors refer to updated chapter of Green Book. Exclusion criteria Acute febrile illness. Within 6 months of a previously administered primary dose of Hepatitis A containing vaccine. Within 25 years of a previously administered booster dose of Hepatitis A containing vaccine. Confirmed anaphylactic reaction to any component or to a preceding dose of a hepatitis A containing vaccine. Children under the age of 12 months. Hypersensitivity to eggs & chicken protein Epaxal vaccine only. Check the manufacturers information prior to administration of any vaccine/immunoglobulin re its latex content. If latex is a component of the vaccine/immunoglobulin or the administration system (e.g. vial or syringe etc.) then a latex-free alternative must be offered to patients with latex sensitivity. Absence of valid consent Precautions Management of excluded patients Action for patients not wishing/unable to receive care under this PGD Immunisation must be postponed in patients with acute febrile illness/infection. Give information about when the vaccine may/may not be given or give a further appointment to attend for vaccination, or in the case of a previous severe allergic reaction be referred to the appropriate medical officer, e.g. CMO, GP. Give hygiene advice and information about Hepatitis A avoidance. Make patient aware of alternative, risks and potential consequences of not being vaccinated. Document refusal. Give advice about hygiene and information about Hepatitis A avoidance.

3 CLINICAL CONTENT OF PATIENT GROUP DIRECTION FOR VERSION (Page 2 of 4) Description of Treatment Name of medicine Formulation and route Strength Dosage Repeated dose instructions Hepatitis A vaccine Intramuscular injection in the deltoid region or anterolateral thigh. Vaccination by deep subcutaneous route must be reserved only for individuals with a bleeding disorder. Prepare as per manufacturers instructions. Not applicable Havrix Monodose - Age 16 years and over 1.0 ml Havrix Monodose Junior - Age 1 year to 15 years 0.5 ml. Avaxim - Age 16 years and over 0.5 ml VAQTA Paediatric Age 1 year to 17 years 0.5ml VAQTA Adult Age 18 years and over ml Epaxal - Age 1 year and over 0.5 ml 6-12 months between first and second doses. Havrix Monodose - second dose may be given up to 5 years after primary dose. Havrix Monodose Junior - second dose may be given up to 3 years after primary dose. Avaxim - second dose may be given up to 3 years after primary dose VAQTA Paediatric - second dose may be given up to 18 months after primary dose. VAQTA Adult - second dose may be given up to 18 months after primary dose Epaxal - second dose may be given up to 10 years after primary dose. If there have been longer gaps between vaccines than advised there is no need to re-start the vaccine course. Further booster dose after 25 years for those at on-going risk. All the above monovalent hepatitis A vaccines can be used interchangeably. Duration of treatment As above Quantity to supply See above Legal status Prescription only medicine (POM) Special Precautions Explain indications, contraindications and cautions (refer to Green Book) Adverse effects Usually mild and confined to the first few days post vaccination. Most common are mild transient soreness, erythema, induration at injection site. A small painless nodule may form at the injection site: this usually disappears and is of no consequence. General symptoms of fever, malaise, fatigue, headache, nausea and loss of appetite are also reported less frequently. This list is not exhaustive. Refer to BNF and SPC for complete list. If serious reaction noted, complete & submit a Yellow Card via For up to date SPCs and PILs Adice necessary Ensure that the patient information leaflet is available & offered to every patient/parent/guardian. Advice on the prevention and management of fever and local reactions and other adverse effects. Common post-vaccination adverse effects. Date of next vaccination as required. Give advice about hygiene and avoiding hepatitis A. Records and Follow Up Referral arrangements Records to be kept Follow up Prior to vaccinating, any health professional administering a vaccination must be able to identify and contact an appropriate medical officer, e.g. CMO, consultant paediatrician, GP, as necessary, e.g. in the case of an immunocompromised child. As per local documentation requirements. Record the brand name of the vaccine given, date and time and route of administration, batch number, expiry date and immunisation site, supply/administration under PGD. Document any reaction in patient s medical notes. Subsequent vaccination as required as per UK schedule Patient Group Direction, organisation and individual authorisation signatures can be found on the managerial content sheet along with other non-clinical details relating to this patient group direction.

4 MANAGERIAL CONTENT OF PATIENT GROUP DIRECTION FOR Patient Group Direction Owner Details of Patient Group Direction owner Patient Group Direction Details VERSION (Page 3 of 4) Name: Martin Samangaya Position: Screening and Immunisation Manager Contact Address: Public Health England, Lancashire Area Team Contact Telephone: Contact msamangaya@nhs.net Date comes into effect 1 ST July 2015 Date of expiry + review 30 th June 2018 or sooner in the light of significant changes in best practice Staff characteristics Registered nurse or Pharmacist employed by the NHS organisations above or independent contractors within them, who has completed immunisation and vaccination training (theoretical and practical) as per local policy, training in the recognition and treatment of anaphylaxis, including practical training in Basic Life Support (annual practice update session to be undertaken) and working under PGDs. Access to adrenaline and access to the complete updated relevant chapters in the current edition of the Green Book Immunisation against Infectious Disease. Patient Group Direction Authorisation Lead Doctor >> YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION << >> OF THIS PGD BEFORE WORKING UNDER IT << Name: Dr Kenneth Lamden Position: Consultant in Health Protection, C&LPHEC Lead Pharmacist Lead Nurse Organisational Authorisation for Lancashire CCGs by Organisational Authorisation by Name: Julie Lonsdale Position: Head of Medicines Performance, Midlands and Lancashire CSU Name: Ms Kate Brierley Position: Acting Deputy Director - Health Protection, C&LPHEC Name: Dr A Manning Position: Deputy Medical Director, Lancashire Area Team, NHS England Name: Position: Authorisation by Independant Contractor (for PGDs being used by the staff of Independant Contractors only) Name: Position: Patient Group Direction Peer Reviewed By Name Position Signature Date Cumbria and Lancashire Vaccine PGD Sub-Group (on behalf of group)

5 MANAGERIAL CONTENT OF PATIENT GROUP DIRECTION FOR Individual Authorisation VERSION (Page 4 of 4) BY SIGNING THIS PATIENT GROUP DIRECTION YOU ARE INDICATING THAT YOU AGREE TO ITS CONTENTS AND THAT YOU WILL WORK WITHIN IT PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY IT IS THE RESPONSIBILITY OF EACH PROFESSIONAL TO PRACTICE ONLY WITHIN THE BOUNDS OF THEIR OWN COMPETENCE IF THIS IS AN UPDATED OR REPLACEMENT PGD ENSURE THAT ALL OLDER VERSIONS ARE WITHDRAWN FROM USE WITH IMMEDIATE EFFECT IT IS YOUR REPONSIBILITY TO MAKE SURE YOU ARE USING THE CURRENT VERSION NOTE TO AUTHORISING MANAGERS: AUTHORISED STAFF SHOULD BE PROVIDED WITH AN INDIVIDUAL COPY OF THE CLINICAL CONTENT OF THE PGD AND A PHOTOCOPY OF THE AUTHORISATION SHEET SHOWING THEIR AUTHORISATION Name of Professional Signature Authorising Manager Date References